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Biomedical subjects

J Mann

Publications and source records attributed to J Mann.

At least 181 records · Page 10Linked to original sources
PubMed1994

Caries experience, treatment needs and treatment supplied among an adult Israeli population.

Information on coronal and root caries in an Israeli adult population including treatment needs has never been conducted. A sample of 2,931 adults ranging in age from 20 to 65 were selected for this longitudinal survey. The sample included both city and kibbutzim dwellers. All examinations were performed by one experienced epidemiologist utilizing the method of Radike for coronal caries. A method outlined by the National Institutes of Health was utilized for scoring of root surface recession and caries. Results indicate a 6.94 decayed and filled teeth (DF-T) mean score for the coronal caries experience and a 2.48 missing teeth (M-T) score. The total decayed and filled surfaces (DF-S) score for the examined population was 11.91. Root DF-S was found to be 1.10 among males and 0.99 among females with a total mean of 1.04. Premolars were found to have more crowns than other teeth, while molars had the highest missing score (1.53). DF-S score of 6.78 was indicated for molars, in addition to a high missing surfaces (M-S) value of 7.63 for molars. Main obstacles to dental care are lack of knowledge and financial barriers. These findings recognize an immediate need for public educational programs and regular professional care in order to increase public awareness of their dental status, encourage improved primary prevention, and seek secondary and tertiary care.

Adult↗
PubMed1993

Pharmacokinetics and pharmacodynamics of benazepril hydrochloride in patients with major proteinuria.

We have investigated whether the pharmacokinetics and pharmacodynamics of the ACE inhibitor benazepril hydrochloride are altered with proteinuria by studying 8 patients with major proteinuria of different causes who were given a single dose of 10 mg p.o. The maximum plasma concentration of benazepril was found between 0.5 and 2 h after dosing (median 1 h). Its elimination was almost complete within 6 h. Peak plasma levels of benazeprilat, the active metabolite of benazepril, were observed between 1 and 6 h (median 2.5 h). The elimination of benazeprilat from plasma was biphasic, with mean initial and terminal half-lives of 3.0 and 17.3 h, respectively. On average, the pharmacokinetic parameters of benazepril and benazeprilat in the patients did not differ from those in a historical control group of healthy volunteers, but intersubject variability in the AUC and half-lives of benazeprilat was greater in the patients. Plasma ACE was completely inhibited from 1.5 to 6 h after dosing, and at 48 h the mean inhibition was still 42%. Plasma renin showed substantial intersubject variation. Mean supine blood pressure (systolic/diastolic) was reduced from baseline by a maximum of 18/13 mm Hg at 6 h. Proteinuria was diminished after benazepril in 7 patients. In conclusion, the results of this study suggest that proteinuria in the nephrotic range does not require a change in benazepril dosage.

Adult↗
PubMed1993

Case report 804: Chondroblastic osteosarcoma grade 3 of the left clavicle.

The summary, the case of a 15-year-old boy with osteosarcoma of the clavicle is presented, prompted by the rarity of primary tumors at that site and by this particular tumor's unusual roentgenographic appearance, which suggested a benign process. A review of the literature on clavicular tumors and malignancies is provided. Though extremely rare, primary tumors of the clavicle are more likely to be malignant than benign. This suggests tht serious consideration should be given to malignancy in the face of an apparently aggressive lesion of the clavicle, and perhaps even a benign-appearing tumor as well.

Adolescent↗
PubMed1993

Effect of isoenergetic intake of three or nine meals on plasma lipoproteins and glucose metabolism.

To investigate the effects of meal frequency on plasma lipid and carbohydrate metabolism, 19 healthy normocholesterolemic free-living men and women consumed their usual diet as three or nine meals per day in random order for 2 wk each. There was no significant difference in macronutrient intake. Compared with the three-meal/d diet, nine meals per day reduced fasting plasma total, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) cholesterol by 6.5% (P < 0.005), 8.1% (P < 0.005), and 4.1% (P < 0.05), respectively. Body weight, fasting triglycerides, apolipoproteins A-I and B, and the LDL-HDL cholesterol ratios were not different for the two diets, as were 24-h urinary C peptide-creatinine ratios and insulin-glucose response to a glucose load. The insulin-glucose curve measured over 3 h in the evening after the evening meal was flatter for the nine meals, but the areas under the curves were not significantly different. Increasing meal frequency while maintaining a constant nutrient intake produces a small but significant decrease in LDL cholesterol in normolipidemic free-living subjects.

Adult↗
PubMed1993

Alcohol intake and the U-shaped curve: do non-drinkers have a higher prevalence of cardiovascular-related disease?

The data from the Oxford Vegetarian Study consists of the observation of around 11,000 individuals followed since the early 1980s. There are around 6000 subjects who do not eat meat and 5000 roughly matched individuals who do. An assiduous questionnaire survey was conducted at recruitment which inquired about health status, diet, drinking and other habits. We have tested the hypothesis that the U-shaped curve relating quantity of alcohol consumed and health is an artefact of selection of some individuals with high consumption and high risk migrating to the no-consumption group but retaining a high risk. The Oxford Vegetarian Study consists of a high proportion of lifelong teetotallers and ex-drinkers, and hence is particularly suitable for testing this hypothesis. We have examined the standardized rates of cardiovascular risk factors among the different dietary and drinking groups separately for men and women, as the bulk of the observed relationship of alcohol with health is mediated through cardiovascular mechanisms. We were unable to find a difference in the prevalence of risk factors between ex-drinkers and teetotallers, but we did find differences associated with dietary practices, particularly among females. These data cast some doubt on the hypothesis that selection may explain the apparent protective effect of moderate drinking when compared with groups currently not drinking (for whatever reason) and heavy drinking.

Alcohol Drinking↗
PubMed1993

A treatment need index: a pilot study.

The traditional caries index, DMF, provides inadequate information to assess dental treatment needs of a community. Dental health planners are often called upon to estimate the treatment needs, costs, time and personnel required for a proposed programme. A treatment needs index (TNI) is presented which provides important data for dental health planning. The index defines seven basic levels of treatment: (0) no treatment needed; (1) preventive treatment; (2) fissure sealants; (3) initial conservative restorations; (4) moderate conservative restorations; (5) advanced conservative restorations; and (6) radical treatment, including pulp therapy, prosthetic restorations and extractions. A pilot study and an example comparing data of both DMF and TNI demonstrates the values of the latter index. The Treatment Needs Index provides a more accurate description of caries severity and extent than does the traditional DMF index, and can be used to estimate the time required to treat a community.

Adolescent↗
PubMed1993

Risk of thrombosis in human atherosclerotic plaques: role of extracellular lipid, macrophage, and smooth muscle cell content.

OBJECTIVE: To assess the size of the lipid pool and the number of smooth muscle cells and monocyte/macrophages in human aortic plaques that were intact and to compare the results with those in aortic plaques undergoing ulceration and thrombosis. DESIGN: The lipid pool was measured as a percentage of the total cross sectional area of the plaque. Immunohistochemistry was used to identify cell types (monocytes/macrophages (M phi) by EBM11 and HAM56, smooth muscle cells by alpha actin). The area of the tissue occupied by each cell type was measured by quantitative microscopy in the peripheral (shoulder) area of the plaque and the plaque cap. Absolute counts of each cell type were expressed as the ratio of SMC:M phi. MATERIAL: Aortas were obtained at necropsy from men aged less than 69 years who died suddenly (within 6 hours of the onset of symptoms) of ischaemic heart disease. 155 plaques from 13 aortas were studied. Four aortas showed intact plaques only (group A, n = 31). Nine aortas showed both intact plaques (group B, n = 79) and plaques that were undergoing thrombosis (group C, n = 45). RESULTS: In 41 (91.1%) of the 45 plaques undergoing thrombosis (group C) lipid pools occupied more than 40% of the cross sectional area of the plaque. Only 12 (10.9%) of the 110 intact plaques (groups A + B) had lipid pools of this size. The mean size of the lipid pool in plaques of groups A, B, and C was 12.7%, 27.3% and 56.7% respectively. Compared with intact plaques those undergoing thrombosis contained a smaller volume of smooth muscle cells (2.8% v 11.8%) and a larger volume of monocyte/macrophages (13.7% v 2.9%) in the plaque cap. The ratio of the number of smooth muscle cells to monocytes/macrophages was 7.8 in group A plaques, 4.1 in group B plaques, and 1.0 in group C plaques. This gradient was the result of an absolute increase in monocyte/macrophages and an absolute decrease in smooth muscle cells. CONCLUSIONS: In the aorta ulceration and thrombosis were characteristic of plaques with a high proportion of their volume occupied by extracellular lipid, and in which there was a shift toward a preponderance of monocyte/macrophages compared with smooth muscle cells in the cap.

Aged↗
PubMed1993

A prospective population-based study of microalbuminuria as a predictor of mortality in NIDDM.

OBJECTIVE: To assess prospectively the relationship between microalbuminuria and mortality in a geographically defined population of NIDDM patients and to determine the relative importance of microalbuminuria as a risk factor for mortality. RESEARCH DESIGN AND METHODS: A survey of known diabetes undertaken in 1982 identified a cohort of 249 NIDDM patients. Follow-up information was available for 246 patients who contributed 1498 person-yr exposure and were followed up for a mean period of 6.1 yr. The median age of the cohort at entry was 68 yr (range 28-89 yr), and the median duration of diabetes was 7 yr (range 1-41 yr). At baseline, a clinical examination was performed and a random daytime urine specimen was obtained for measurement of urinary albumin concentration. RESULTS: UAC results were available for 236 patients: 45 (19%) patients had a UAC > 15- < 40 mg/L; 36 (15%) had a UAC 40-200 mg/L; 10 (4%) had a UAC > 200 mg/L; and 145 (61%) had a normal UAC < or = 15 mg/L. During the follow-up period, 93 patients died. All-causes mortality, expressed as standardized mortality ratio (SMR = 149) and coronary heart disease mortality (CHD SMR = 166) were significantly increased. This excess mortality was significant in women (all-causes SMR = 194, CHD SMR = 234) but not in men (all-causes SMR = 118, CHD SMR = 128). On univariate analysis, systolic blood pressure was the only significant association with albumin concentration (P = 0.0002). An age-stratified log-rank test was conducted to determine the effect of potential explanatory variables on survival. Survival distributions were significantly different for known duration of diabetes (P = 0.045), intermittent claudication (P = 0.012), severity of retinopathy, lens opacity (P < 0.001) and UAC (P = 0.013) and diastolic blood pressure approached significance (P = 0.051). After adjusting for the effects of these potentially confounding variables identified by the log-rank analysis, significant predictors of early mortality on multivariate survival analysis were age, UAC of 40-200 mg/L (relative risk = 2.2, 95% confidence interval 1.3-3.7), more severe retinopathy (relative risk = 3.4, 95% confidence interval 1.9-6.0), and lens opacity (relative risk = 2.4, 95% confidence interval 1.6-3.8). CONCLUSIONS: The findings from this population-based cohort confirm the predictive power of microalbuminuria as a risk factor for mortality in NIDDM. In contrast to prospective studies of conventional cardiovascular risk factors in NIDDM, consistent evidence indicates that microalbuminuria is an independent predictor of excess mortality regardless of the collection procedure used.

Adolescent↗
PubMed1993

Dental underemployment: a study of uncontrolled dental manpower immigration.

In the 1980s three studies were conducted in Israel utilising different methods of dental manpower evaluations. All identified a large future surplus of dentists. The current study re-evaluates the manpower supply and discusses possible solutions. A random sample of 800 dentists was approached by three mailings and a telephone call follow-up with a response of 49.7 per cent. Almost 90 per cent of dentists reported an undersupply of patients, with a mean working load of 26.3 hours/week, but being willing to add up to 3.4 working hours/week. The oversupply of dentists has been dramatically affected by the addition of almost 1000 dentists who emigrated to Israel in 1991-92. To prevent a significant unemployment rate among dentists and an uncontrolled free market, it is urgently suggested for the benefit of both provider and consumer that; the demand for services be increased and additional financing of dental care be made available, that the total number of dentists be decreased by various measures and that their geographical distribution be improved. If necessary limits should be placed on the number of practices or the number of patients permitted per practice.

Adult↗
PubMed1992

Fatal myocardial infarction and use of psychotropic drugs in young women.

We have observed an unexpected 17-fold increase in risk of fatal [corrected] myocardial infarction (relative risk 16.9, 95% confidence interval 3.9-72.8) associated with current use of psychotropic drugs. This incidental finding, in a case-control study of cardiovascular mortality in women aged 16-39 not designed to test any hypothesis about psychotropic drugs, should be treated cautiously. There is, however, evidence of a relation between psychiatric morbidity and cardiovascular disease and the association recorded here requires further investigation.

Adolescent↗